Alarm bells sound as financial scrutiny falls victim to the cuts

If ever there was a time to ensure that financial scrutiny within the NHS was as robust as possible, this is surely it. Areas of efficiency and waste need to be identified and learning spread as a vital ingredient of achieving the £20bn savings target.

If ever there was a time to ensure that financial scrutiny within the NHS was as robust as possible, this is surely it

The financial impact on services affected by reconfiguration needs to be thoroughly examined, as does the health of trusts being accelerated towards foundation status. Spending habits of primary care trusts - distracted and demoralised - need to be watched, and then there is the fantastically thorny issue of who and how you audit GP commissioning consortia.

Overarching all of this is the need to maintain a consistent approach to NHS financial management, in part to reassure the Treasury that the only ringfenced major department is spending its money wisely.

With the commission’s impending demise, and Monitor becoming the new economic regulator, this burden is settling firmly on the Department of Health’s shoulders and chief executive Sir David Nicholson’s “national management service”.

Given the DH is going through its own slimming exercise, this seems a dangerous piece of risk management. It will also weaken independent examination of the financial implications of the new policy.

Last week, HSJ warned of the dangers of no longer monitoring the quality of PCT performance. Now there seems to be a real danger that, through confusion about future arrangements and the distraction of competing policy, financial scrutiny may reduce too. That should alarm everyone with an interest in the immediate future of the NHS.